Manipulation of hip fracture in the below-knee amputee

Alharthy, Abdulrahman; Abed, Rana I.; Campbell, A.C.

doi:10.1016/s0020-1383(97)00118-6

Cited by 22 publications

(26 citation statements)

References 2 publications

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“…Concerns are raised by other authors that the use of skeletal traction is associated with risks of infection and cutting out of the pin, particularly in amputees, due to the relative avascularity of the limb and high incidence of osteoporosis 9 10. We acknowledge this is the case but felt on balance a femoral Steinmann Pin would provide the best setup for a satisfactory surgical outcome.…”

Section: Discussionmentioning

confidence: 90%

“…While these techniques allow, according to the authors, for adequate imaging they do not permit traction or manipulation of the limb and therefore reduction by indirect means. A third technique uses an inverted traction boot to secure the below-knee stump with the knee flexed 10. This technique does permit manipulation of the limb but is only suitable in below-knee amputees.…”

Section: Discussionmentioning

confidence: 99%

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Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique

Berg

Bhatia

2014

BMJ Case Reports

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SUMMARYWhile neck of femur fractures are common it is rare to see this injury in a bilateral leg amputee. Special consideration needs to be given to the management of these patients. We report the case of a 58-year-old man with bilateral leg amputation who presented to the emergency department with left hip pain following a fall. A fracture of the left neck of femur with extension into the femoral shaft was diagnosed. Internal fixation was planned with a dynamic hip screw. Standard fracture table setup, which allows for traction of the fractured limb and positioning of the contralateral limb such that anteroposterior and lateral X-rays can be obtained, was not possible in this case due to the amputations. We highlight considerations that need to be made in positioning a bilateral amputee for neck of femur fracture fixation and also highlight an improvised technique that can be utilised by other surgeons. BACKGROUND

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique

Berg

Bhatia

2014

BMJ Case Reports

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“…Internal fixation of a displaced neck of femur fracture in patients with an ipsilateral below-knee amputation is difficult [12]. Due to altered biomechanics (i.e., increased proximal excursion of the hip, lateralization of the centre of gravity, and increased shear forces) at the fracture site in patients with below-knee amputations, a high risk of fixation failure or nonunion exists [6].…”

Section: Discussionmentioning

confidence: 99%

Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot

Döring

Vochteloo

Doorn

et al. 2016

Case Reports in Orthopedics

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This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis. Treating patients with this type of comorbidities is challenging; therapeutic dilemmas can be major. The management in cases like these requires a thorough evaluation and a clear surgical and medical treatment plan, preferably conducted by a multidisciplinary orthogeriatric team.

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“…However, this conventional method could not be used in our patient, who had bilateral above-knee amputations with short stumps (10 cm on the left and 12 cm on the right). So far, one relevant operation technique was published in the literature regarding closed reduction and fixation of such a fracture in a patient with a unilateral below-knee amputation [5,6]. The authors describe flexing the knee and securing the padded stump to the inverted traction boot; the stump and knee act as a pseudo foot and ankle, thus allowing traction to be applied to the limb.…”

Section: Discussionmentioning

confidence: 99%

A simple technique to position patients with bilateral above-knee amputations for operative fixation of intertrochanteric fractures of the femur: a case report

et al. 2010

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IntroductionIntertrochanteric fractures of the femur are common fractures in the elderly, and management includes operative fixation after patient positioning on the fracture table. Patients with bilateral above-knee amputations are challenging in terms of positioning on the table. We describe a simple technique to overcome this special problem.Case presentationA 75-year-old wheelchair-bound Caucasian man with bilateral above-knee amputations presented to our hospital after a fall. Plain radiographs showed an intertrochanteric fracture of the femur, and operative fixation with a dynamic hip screw was planned. His positioning on the table posed a particular problem, and therefore we developed a technique to overcome this problem.ConclusionPositioning of patients for fixation of intertrochanteric fractures of the femur poses a particular problem that can be solved by using our simple technique.

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Manipulation of hip fracture in the below-knee amputee

Cited by 22 publications

References 2 publications

Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique

Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique

Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot

A simple technique to position patients with bilateral above-knee amputations for operative fixation of intertrochanteric fractures of the femur: a case report

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